OBJECTIVE: To review new developments in transdermal E2 therapy in postmenopausal women. DESIGN: A bibliographic search (Medline) of the medical literature from 1966 through 1995 was used to identify new studies evaluating transdermal E2. PATIENT(S): Menopausal and postmenopausal women. RESULT(S): Like oral estrogen, transdermal E2 relieves menopausal symptoms, reverses urogenital atrophy, and conserves bone economy. Initial studies have demonstrated beneficial effects of transdermal E2 on cardiovascular function. Quality of life, patient satisfaction, and compliance also improve with transdermal E2. Advances in transdermal delivery continue to emerge, including low-dose systems and patches that maintain serum E2 levels for a full 7-day period. CONCLUSION(S): New developments in transdermal administration have the potential to increase the number of postmenopausal women who accept and are compliant with long-term estrogen replacement therapy.